Z Gastroenterol 2025; 63(08): e553-e554
DOI: 10.1055/s-0045-1810980
Abstracts | DGVS/DGAV
Kurzvorträge
Prognoseparameter und Therapiekonzepte bei HCC Freitag, 19. September 2025, 09:51 – 11:11, Seminarraum 14 + 15

Patterns of radiological progression in participants (pts) with embolization-eligible hepatocellular carcinoma (HCC) treated with durvalumab (D)+bevacizumab (B)+transarterial chemoembolization (TACE) and placebos+TACE: EMERALD-1 post hoc analysis

C Roderburg
1   University Hospital of Düsseldorf, Department of Gastroenterology, Hepatology and Infectiology, Düsseldorf, Deutschland
,
B Sangro
2   Clínica Universidad de Navarra and CIBEREHD, Liver Unit and HPB Oncology Area, Pamplona – Madrid, Spanien
,
M Bouattour
3   AP-HP Hôpital Beaujon, Liver Cancer and Innovative Therapy, Paris, Frankreich
,
J-W Park
4   National Cancer Center and Myongji Hospital, Department of Gastroenterology and Hepatology, Center for Liver and Pancreatobiliary Cancer, Goyang, Korea, Republik
,
M del Consuelo Díaz Romero
5   Instituto Nacional de Cancerología, Mexico City, Mexiko
,
J P Erinjeri
6   Memorial Sloan Kettering Cancer Center, Interventional Radiology Service, New York, Vereinigte Staaten
,
G Alves
7   Hospital Nossa Senhora de Conceição, Centro Integrado de Pesquisa em Oncologia, Porto Alegre, Brasilien
,
S Gu
8   Hunan Cancer Hospital, Department of Interventional Radiology, Changsha, China
,
A Manikhas
9   City Clinical Oncological Dispensary, Oncology Department, St. Petersburg, Russische Föderation
,
H Kuroda
10   Iwate Medical University, Division of Hepatology, Department of Internal Medicine, Morioka, Japan
,
T Suksombooncharoen
11   Chiang Mai University, Department of Internal Medicine, Faculty of Medicine, Chiang Mai, Thailand
,
T Hoi Trung Vo
12   Cho Ray Hospital, Liver Tumor Department, Ho Chi Minh City, Vietnam
,
V S Ostwal
13   Tata Memorial Hospital, Tata Memorial Centre, Department of Medical Oncology, Mumbai, Indien
,
M Eastgate
14   Royal Brisbane and Women's Hospital, School of Medicine, University of Queensland and Department of Medical Oncology, Brisbane, Australien
,
G Vaccaro
15   Tennessee Oncology, Nashville, Vereinigte Staaten
,
R Griffin
16   AstraZeneca, Oncology Biometrics, Late Oncology Statistics, Cambridge, Vereinigtes Königreich
,
S Ali
17   AstraZeneca, Global Medicines Development, Cambridge, Vereinigtes Königreich
,
K Balaji
18   AstraZeneca, Global Medical Affairs, Gaithersburg, Vereinigte Staaten
,
S L Chan
19   The Chinese University of Hong Kong, Department of Clinical Oncology, Prince of Wales Hospital, Sir Yue-Kong Pao Center for Cancer, Hong Kong, China
› Author Affiliations
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Background: EMERALD-1 (NCT03778957) met its primary endpoint, demonstrating improved PFS in pts with locoregional HCC treated with D+B+TACE vs. placebos (PBO)+TACE (stratified Cox proportional hazards hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.61–0.98. This post hoc analysis assessed outcomes by radiological progression pattern (radPP) in pts treated with D+B+TACE or PBO+TACE.

Methods: Pts included in this analysis received D (1500 mg) or PBO for D (Q4W) combined with conventional (c)- or drug-eluting bead (DEB)-TACE (investigator choice, 1–4 TACE procedures within 16 weeks). Subsequently, pts received D (1120 mg)+B (15 mg/kg), or PBO for D+B (Q3W). This study analyzed radPP at the time of first progressive disease (PD) as assessed by the investigator per modified Response Evaluation Criteria in Solid Tumors. A new lesion was classified as a new intrahepatic lesion (NIH) or new extrahepatic lesion (NEH); tumor growth of existing intrahepatic lesions (increase of≥20% of an existing target lesion with at least>5 mm absolute increase or unequivocal PD with a non-target lesion) was classified as intrahepatic growth (IHG; categories weren´t mutually exclusive). Efficacy was assessed by time to progression (TTP).

Results: In the D+B+TACE arm, 53.9% of pts had PD, & in the PBO+TACE arm 79.0% of pts had PD. The most common pattern of disease progression across both treatment arms was NIH (73 (35.8%) in the D+B+TACE & 107 (52.2%) pts in the PBO+TACE), with 31 (15.2%) & 34 (16.6%) pts exhibiting IHG, & 24 (11.8%) & 39 (19.0%) pts exhibiting NEH. Improved TTP was observed in pts treated with D+B+TACE vs. PBO+TACE, regardless of progression pattern.

Conclusions: The rate of progression was lower with D+B+TACE compared with PBO+TACE. The pattern of disease progression observed with D+B+TACE & PBO+TACE was similar, with NIH the most common pattern of progression in both treatment arms. Consistent benefit in TTP was observed with D+B+TACE vs. PBO+TACE, regardless of progression pattern.

Funding: AstraZeneca

Acknowledgments: Medical writing support, under the direction of the authors, was provided by Victoria Harle, PhD, CMC Connect, a division of IPG Health Medical Communications, & was funded by AstraZeneca, in accordance with Good Publication Practice guidelines.

© 2025 American Society of Clinical Oncology, Inc. Reused with permission. This abstract was accepted & previously presented at the 2025 Gastrointestinal Cancers Symposium. All rights reserved.



Publication History

Article published online:
04 September 2025

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